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Original papers: Robert Chaplin, Maureen McGeorge, and Paul Lelliott The National Audit of Violence: in-patient care for adults of working age Psychiatr Bull 2006; 30: 444-446 [Abstract] [Full text] [PDF]

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Post-incident debriefing following Physical Violence between patients and staff

Ravi S Sohal   (8 January 2007)

Post-incident debriefing following Physical Violence between patients and staff 8 January 2007
Ravi S Sohal, Specialist Registrar Send letter to journal: Re: Post-incident debriefing following Physical Violence between patients and staff dr.ravi{at}doctors.org.uk Ravi S Sohal	The National Audit of Violence highlighted many important issues which can reduce the risk of violence in in-patient settings (Chaplin et al., 2006). In 2004-5, 43 000 physical assaults occurred in mental health trusts. The adverse effects on the mental health of staff and effective interventions to manage these sequelae tend to be neglected in research. Although debriefing remains controversial, the National Institute for Clinical Excellence (NICE) recommended a post-incident review take place within 72 hours of an incident (NICE, 2005). In an audit on post-incident debriefing reviews following physical violence, I administered a questionnaire by telephone to the ward managers of all adult in-patient units at the Central & North-West London mental health trust. All 4 psychiatric intensive care units (PICUs) and 18 out of 19 adult psychiatric wards participated in the audit. All PICUs and 14 (82%) of adult psychiatric wards stated that they would arrange reviews within 72 hours of an incident of physical violence, and the remainder within 1 week. However, over a 6 month period in 2006, only half of PICUs and one- third of general adult wards consistently arranged post-incident reviews following each incident of physical violence which was reported by incident forms. The audit highlighted a need for training ward managers to lead post- incident reviews and significant practical difficulties in organising reviews, due to problems such as availability of staff and lack of time, that face many acute psychiatric wards (Lelliot et al, 2006). Organisational changes will reduce the risk of violence but incidents will continue to occur and provisions should also be put in place to support staff and patients. Chaplin, R., McGeorge, M. & Lelliot, P. (2006) The National Audit of Violence: in-patient care for adults of working age. Psychiatric Bulletin. 30, 444-446. Healthcare Commission. (2005). The National Audit of Violence (2003 -2005). Final report http://www.healthcarecommission.org.uk/_db/_documents/04017451.pdf Lelliot, P., Bennett, H., McGeorge, M & Turner, T. (2006) Accreditation of acute in-patient mental health services. Psychiatric Bulletin. 30, 361-363. Author: Dr Ravi Sohal, Specialist Registrar in General Adult Psychiatry, Mental Health Centre, Northwick Park Hospital, Watford Road, Harrow, Middx. HA1 3UJ Tel No: 020 8869 2305 Fax No: 020 8869 2291 Declaration of Interest: None